How can I support parents supporting a depressed and anxious son?
September 26, 2015 6:10 AM Subscribe
My teenage brother has been struggling with pretty severe anxiety and depression for the last ~9 months; while my parents are being (in my view) amazing caregivers for him, I think they're both suffering from a lack of self-care, optimism, and support. What resources can I point them to, and what can I do, to help them with this?
The reason I say self-care is because they (particularly my mom) seem to spend most of their day worrying about him (and whether he went to school today and whether he had a panic attack in school and whether he'll make it to sports practice and what tomorrow and next month and next year will be like), to the point that it's monopolizing their lives. My mom isn't open to any sort of other activities (she did have some light participation in a few hobby-type things, but is stressed out by the idea of going since this episode started - in general, anything with a time commitment, including therapy for herself, is proving hard to convince her of), can't bring herself to discuss the future ("I can't talk about travel next summer, I just really need to focus on your brother right now"), etc. and I think it's hurting her. My dad is less vocal about it but is probably struggling with similar things.
My mom has good friends who have dealt with mental health struggles with their own children, and are a great source of support, but I wonder if those friends are also a little exhausted and whether they might be assuming that what worked for them translates to one-size-fits-all advice.
They have been great parents though this, and they are lucky in that his school/extracurriculars/friends have been very supportive and adaptive as well. My parents are understanding and listen to what he has to say (when he's able to vocalize things), consistently take it as seriously as any other health problem, and have been very flexible about how he spends his time (stepping down academic commitments significantly, recognizing video games with friends as valuable social time, trying to make whatever he wants happen, similar things that they would probably never have done before this). Probably because of that, he hasn't shut them out and is comfortable sharing whatever details he can articulate with them (which isn't many). I think in general they are doing a much better job than some friends' parents I've seen, though they are not well-versed in treatment options are are stuck in a sort of rut about that.
He's tried several therapists and sees a psychiatric nurse practitioner (because of a lack of in-network psychiatrists), and they're still unsuccessfully looking for a good fit (at this point, he thinks the therapy is useless and isn't crazy about going but still goes. He's also very shy around other adults and so has trouble asserting his needs in academic, medical, and other situations, which makes me think he may not open up much around therapists). The single thing that has helped the most has been when I and/or my other brother were living at home, but I'm currently remote because of my job and come January my brother will be returning to college; both of us have school/work on the opposite coast from our family. It isn't a situation that can change easily in the near future.
Useful resources would be books, specific articles, groups (or listings of groups - they live in a large city), advice for me, anecdotes I could relate without revealing that I asked this on their behalf, and anything else concrete that I may not have thought of. I think they could use advice about self-care, treatment options, optimistic anecdotes, and clinical information. I don't think they would take advantage of online forums or something similarly open-ended.
Anon email: helpmybrother@metafilter.33mail.com
The reason I say self-care is because they (particularly my mom) seem to spend most of their day worrying about him (and whether he went to school today and whether he had a panic attack in school and whether he'll make it to sports practice and what tomorrow and next month and next year will be like), to the point that it's monopolizing their lives. My mom isn't open to any sort of other activities (she did have some light participation in a few hobby-type things, but is stressed out by the idea of going since this episode started - in general, anything with a time commitment, including therapy for herself, is proving hard to convince her of), can't bring herself to discuss the future ("I can't talk about travel next summer, I just really need to focus on your brother right now"), etc. and I think it's hurting her. My dad is less vocal about it but is probably struggling with similar things.
My mom has good friends who have dealt with mental health struggles with their own children, and are a great source of support, but I wonder if those friends are also a little exhausted and whether they might be assuming that what worked for them translates to one-size-fits-all advice.
They have been great parents though this, and they are lucky in that his school/extracurriculars/friends have been very supportive and adaptive as well. My parents are understanding and listen to what he has to say (when he's able to vocalize things), consistently take it as seriously as any other health problem, and have been very flexible about how he spends his time (stepping down academic commitments significantly, recognizing video games with friends as valuable social time, trying to make whatever he wants happen, similar things that they would probably never have done before this). Probably because of that, he hasn't shut them out and is comfortable sharing whatever details he can articulate with them (which isn't many). I think in general they are doing a much better job than some friends' parents I've seen, though they are not well-versed in treatment options are are stuck in a sort of rut about that.
He's tried several therapists and sees a psychiatric nurse practitioner (because of a lack of in-network psychiatrists), and they're still unsuccessfully looking for a good fit (at this point, he thinks the therapy is useless and isn't crazy about going but still goes. He's also very shy around other adults and so has trouble asserting his needs in academic, medical, and other situations, which makes me think he may not open up much around therapists). The single thing that has helped the most has been when I and/or my other brother were living at home, but I'm currently remote because of my job and come January my brother will be returning to college; both of us have school/work on the opposite coast from our family. It isn't a situation that can change easily in the near future.
Useful resources would be books, specific articles, groups (or listings of groups - they live in a large city), advice for me, anecdotes I could relate without revealing that I asked this on their behalf, and anything else concrete that I may not have thought of. I think they could use advice about self-care, treatment options, optimistic anecdotes, and clinical information. I don't think they would take advantage of online forums or something similarly open-ended.
Anon email: helpmybrother@metafilter.33mail.com
Your brother sounds a lot like my daughter (except dau has had a much longer documented history of mental health difficulties). She did therapy on and off (more off than on) but her whole social anxiety component made it hard for her to engage in therapy when she was there. We did find a therapist at one point (out of network, natch) that she clicked with more than most but it was still difficult to sustain that relationship for more than a few months.
At any rate, my point here is that if your brother is not really opening up/engaging with therapists, it can be doubly helpful for your parents (probably your mom, emotional labor yada yada) to have a therapist of their own both as a support tool for their own mental health (which can take SUCH a beating dealing with an unstable kid) and in terms of strategizing on how they might pass along some of the "therapy" tools that a more engaged patient would get directly from their own therapist. In my case, I know in my heart of hearts that my daughter (just started college, still living at home) would get a lot out of DBT, but right now she's acceptably stable, still not interested in therapy, and I've set that option out there for her like so much broccoli on a plate, and she's so far been, "um, yeah, I don't like broccoli so I'll take a pass, thanks." But fortunately, I have my own therapist and I swear we spend nearly all of our sessions hashing through "conversations" to have with her (and my husband) to help them help themselves, including sharing tools from CBT, DBT, etc. So it's kind of like I'm predigesting the broccoli for her, or chopping it up and hiding it in the little everyday conversations we are still able to have about situations where she felt stressed or anxious or unmotivated or whatever.
If that's not on the cards, there are a few books out there that are addressed at parents of kids/teens with diagnosis X. These, and other exercises in empathy, have been really helpful to me, insofar as I've had my own struggles with depression but it's been a process to learn to have empathy for the anxiety (and in her case, eating disorder) component, which is not a part of my own mental health experience.
posted by SomeTrickPony at 8:01 AM on September 26, 2015 [2 favorites]
At any rate, my point here is that if your brother is not really opening up/engaging with therapists, it can be doubly helpful for your parents (probably your mom, emotional labor yada yada) to have a therapist of their own both as a support tool for their own mental health (which can take SUCH a beating dealing with an unstable kid) and in terms of strategizing on how they might pass along some of the "therapy" tools that a more engaged patient would get directly from their own therapist. In my case, I know in my heart of hearts that my daughter (just started college, still living at home) would get a lot out of DBT, but right now she's acceptably stable, still not interested in therapy, and I've set that option out there for her like so much broccoli on a plate, and she's so far been, "um, yeah, I don't like broccoli so I'll take a pass, thanks." But fortunately, I have my own therapist and I swear we spend nearly all of our sessions hashing through "conversations" to have with her (and my husband) to help them help themselves, including sharing tools from CBT, DBT, etc. So it's kind of like I'm predigesting the broccoli for her, or chopping it up and hiding it in the little everyday conversations we are still able to have about situations where she felt stressed or anxious or unmotivated or whatever.
If that's not on the cards, there are a few books out there that are addressed at parents of kids/teens with diagnosis X. These, and other exercises in empathy, have been really helpful to me, insofar as I've had my own struggles with depression but it's been a process to learn to have empathy for the anxiety (and in her case, eating disorder) component, which is not a part of my own mental health experience.
posted by SomeTrickPony at 8:01 AM on September 26, 2015 [2 favorites]
I got a little weepy reading this. I was that parent, and I didn't have a nice son like you to check in with me. Keep doing what you are doing. Show them that you care. Tell them that you think they are good parents and are doing everything that they need to do. I'm sure that you have seen how isolating caring for a child with an anxiety disorder can be. People get so judgemental. They don't understand that you aren't spoiling your child or giving into demands, you are trying to get from point a to point b without the anxiety monster spiralling out of control. Keep giving your parents' positive feedback to override all the ugly that they are getting from those who don't understand.
While I was in the worst of it with my child, I too forgot about self care. Remind them to eat well and to cook things that they like, even your brother won't eat it. Remind them that it is okay to go for long walks or out to a movie sometimes, if your brother can be left alone.
Hospitalization is not to be considered a failure. Sometimes it is needed to get a full work up and a medication adjustment. If you see things are getting too hard for them to handle on their own, you may want to suggest some hospitals in your area that treat young adults. Do your research. An emergency hold at a hospital sends the patient to the nearest empty bed, even if it is at a horrible place. By knowing what is available ahead of time, you can can call ahead and find out what day a bed is open at a good place.
Your parents would both benefit from therapy for themselves. Do encourage them to find someone to talk to. One day your brother will be okay and they need to have some of themselves left to live after that happens. Remind them that one day he will be okay. It does get better.
posted by myselfasme at 10:47 AM on September 26, 2015 [1 favorite]
While I was in the worst of it with my child, I too forgot about self care. Remind them to eat well and to cook things that they like, even your brother won't eat it. Remind them that it is okay to go for long walks or out to a movie sometimes, if your brother can be left alone.
Hospitalization is not to be considered a failure. Sometimes it is needed to get a full work up and a medication adjustment. If you see things are getting too hard for them to handle on their own, you may want to suggest some hospitals in your area that treat young adults. Do your research. An emergency hold at a hospital sends the patient to the nearest empty bed, even if it is at a horrible place. By knowing what is available ahead of time, you can can call ahead and find out what day a bed is open at a good place.
Your parents would both benefit from therapy for themselves. Do encourage them to find someone to talk to. One day your brother will be okay and they need to have some of themselves left to live after that happens. Remind them that one day he will be okay. It does get better.
posted by myselfasme at 10:47 AM on September 26, 2015 [1 favorite]
Keep telling your parents that they are good parents and how much you respect what they are doing. Also let them know that you are watching and learning from them by example how to deal with adversity, how to love unconditionally and any other family values that you see in action.
My your mother would be open to doing something (an exercise class would be great if she wasn't open to therapy) during the day while your brother is at school. (Assuming he is mostly getting to school.) If a regular class won't work (because your brother stays home from school too often), maybe you can help her find a drop in program or a personal trainer that she can easily reschedule at the last minute.
Is there something you can for them? I would love to be able to delegate having to maintain a spreadsheet of which claims got paid and which didn't (easy to delegate since it is available on-line) and, even better talk to the insurance company about the problems (a little harder to delegate plus they would need to give the insurance company written permission to talk to you) Depending on your age and financial picture they might not want to do that, but it is one idea. another idea would be to offer to take the lead on planning a family event - figuring out the details for a family Christmas, taking the lead in planning menus and reservations etc.
If you have a relationship with your brother, try to check with him regularly when you are away. Maybe a weekly phone call, maybe jointly playing an on-line game. It will not only be good for you but it will make your parents feel better to know that you care and are connected with your brother.
Finally, be gentle with your advice. We went through some really tough stuff with my youngest and husband refused to talk to anyone about it. I tried a few times and finally told him it was his decision and I would leave it alone unless I thought it was really impacting his health. He never talked to anyone but we all survived, each in their own way.
posted by metahawk at 2:20 PM on September 26, 2015
My your mother would be open to doing something (an exercise class would be great if she wasn't open to therapy) during the day while your brother is at school. (Assuming he is mostly getting to school.) If a regular class won't work (because your brother stays home from school too often), maybe you can help her find a drop in program or a personal trainer that she can easily reschedule at the last minute.
Is there something you can for them? I would love to be able to delegate having to maintain a spreadsheet of which claims got paid and which didn't (easy to delegate since it is available on-line) and, even better talk to the insurance company about the problems (a little harder to delegate plus they would need to give the insurance company written permission to talk to you) Depending on your age and financial picture they might not want to do that, but it is one idea. another idea would be to offer to take the lead on planning a family event - figuring out the details for a family Christmas, taking the lead in planning menus and reservations etc.
If you have a relationship with your brother, try to check with him regularly when you are away. Maybe a weekly phone call, maybe jointly playing an on-line game. It will not only be good for you but it will make your parents feel better to know that you care and are connected with your brother.
Finally, be gentle with your advice. We went through some really tough stuff with my youngest and husband refused to talk to anyone about it. I tried a few times and finally told him it was his decision and I would leave it alone unless I thought it was really impacting his health. He never talked to anyone but we all survived, each in their own way.
posted by metahawk at 2:20 PM on September 26, 2015
Encourage your parents, your mother especially in self care, by pointing out that she needs to role model healthy ways of dealing with anxiety, and at the moment, spending a lot of time worrying, telling herself she doesn't have any other options, and giving up on enjoyable activities, is exactly what she DOESN'T want to model.
They need support, therapy and social time too.
The Woman's Comfort Book was soothing to me when I was stressed enough I had trouble picking non stressful activities.
posted by Elysum at 5:21 PM on September 26, 2015
They need support, therapy and social time too.
The Woman's Comfort Book was soothing to me when I was stressed enough I had trouble picking non stressful activities.
posted by Elysum at 5:21 PM on September 26, 2015
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An excellent support network and list of resources is available through NAMI. Specifically, the secton on Teens and Young Adults. Your family is already several steps ahead.
You seem to be on the right path, and aware of the potential pitfalls.
posted by RainyJay at 6:59 AM on September 26, 2015 [2 favorites]